Search Results (53,735)

This article presents the design and development of an interactive architecture oriented toward the management of traditional vallenato, a musical genre recognized as an Intangible Cultural Heritage of Humanity by UNESCO. Architecture combines the principles of contextual awareness and the use of massive open online courses (MOOCs) to face the current challenges of preservation, dissemination, and teaching of this cultural expression, threatened by commercialization and the loss of its traditional roots. Through a modular structure, adaptive technological tools are integrated to capture, process, and use contextual information, personalizing learning experiences and strengthening the link between communities and their cultural heritage. The proposal consists of several functional layers, including context management, user profiles, educational resources, and a persistence unit, each designed to ensure the interoperability and sustainability of cultural data. In addition, the capacity of architecture to be used in other cultural contexts is highlighted, expanding its impact on different artistic manifestations and heritages worldwide. This article includes a comparative analysis with other existing models, highlighting the advantages of this solution in terms of customization and adaptability. Finally, opportunities for improvement and expansion are explored, as well as the pending challenges in the implementation of this technological tool in educational and cultural environments. Full article

Background: Photodynamic therapy (PDT) has emerged as a powerful minimally invasive modality for cancer treatment. However, its efficacy as a monotherapy is often limited by oxygen dependence and limited light penetration. Combining PDT with systemic anticancer drug therapies offers a promising strategy to achieve synergistic effects and overcome resistance. Objective: This review aims to provide a systematic analysis of the mechanisms and clinical potential of combining PDT with chemotherapy, targeted therapy, and immunotherapy, focusing on recent advancements and nanotechnology-based delivery systems. Methods: A comprehensive literature search was performed using PubMed and Scopus databases. The analysis focused on peer-reviewed studies published over the last 10 years addressing synergistic molecular pathways, co-delivery nanoplatforms, and clinical trial outcomes. Results: The combination of PDT with chemotherapy enhances drug accumulation via vascular photosensitization and can overcome multi-drug resistance. Integration with immunotherapy, particularly immune checkpoint inhibitors and tumor vaccines, triggers immunogenic cell death (ICD), leading to systemic antitumor responses. Nanotechnology provides a versatile platform for the targeted co-delivery of photosensitizers and pharmacological agents, significantly reducing systemic toxicity. Conclusions: Combined PDT–drug regimens demonstrate superior therapeutic efficacy compared to monotherapies. Future clinical translation requires the standardization of dosimetry and the development of multifunctional nanomedicines to enable personalized treatment protocols. Full article

The scope of actual pro-environmental initiatives, programs, interventions, and campaigns is limited. Therefore, spillover effects from these activities to other domains of economy, the private sphere, and society are crucial to achieve a transformation of society towards sustainability. Starting from the known literature and using Google Scholar as a platform for searching additional studies, this explorative, traditional narrative review analyses behavioural spillover effects, where either one behaviour influences the likelihood of another behaviour, or an intervention shows an impact on an environmentally significant behaviour, which it did not primarily address. In the scientific literature, spillover is classified by direction (environmentally positive versus negative), involved behaviours (similar or cross-behavioural), timing (short or long term), context (e.g., work to private life), and social scope (personal, interpersonal, intra- and inter-organisational, intergroup, or international). Positive spillover can result from cognitive dissonance reduction, consistent self-perception, pro-environmental values, norms, self-identity, action-based learning, and habit formation. Negative spillover emerges through rebound effects, moral licensing, and psychological reactance. Stronger spillover is observed between similar behaviours, while cross-domain spillover is generally weaker. According to previous research, a facilitated participatory approach with strong pro-environmental orientation appears recommendable for practitioners to foster the value change required for effective and sustained positive spillover. Full article

Purpose: This study provides a critical examination of the literature on applying artificial intelligence (AI) and Extended Reality (XR) in restaurant settings and related foodservice operations. It focuses on how AI and XE influence consumer nutrition awareness and decision-making about food choices, and their implications for customer satisfaction, loyalty, and service delivery in foodservice environments. Design/methodology/approach: The study adopts a systematic literature review (SLR) approach following the PRISMA method. An initial search identified over 3900 academic papers published between 2016 and 2025. Studies were selected on the basis of predetermined inclusion and exclusion criteria, and 26 peer-reviewed articles were analyzed. The review provides a conceptual synthesis and develops propositions for practical applications and future research directions. Findings: The review reveals a shift from static systems that rely on optimization, toward adaptive and user-centered solutions that are behavior-oriented. AI applications predominate in the case of calorie tracking, personalized recommendations, and menu planning. Though deployment of XR technologies (e.g., AR and VR) is less prevalent, they offer potential for immersive, and real-time interventions. A key distinction emerges between studies demonstrating empirical effectiveness (e.g., improved understanding and healthier choices) and those focused on technical and/or conceptual developments. To date, there has been limited validation of behavioral impacts in foodservice settings. Originality: This study offers a theory-informed conceptualization of AI and XR applications in restaurant and foodservice contexts by integrating three perspectives: hospitality (menus and dining experience), nutrition (dietary awareness and healthier choices), and human–technology interaction (technology acceptance and user engagement). The study reconceptualizes AI- and XR-enabled systems as behavioral intervention tools and outlines a focused research agenda for advancing nutritional communication in foodservice environments. Full article

Hungarian teachers’ reform priorities remain insufficiently mapped, despite their central role in shaping feasible, evidence-based educational change. In a cross-sectional study with 1254 kindergarten, primary, and secondary teachers across Hungary (May 2025), we elicited and analyzed open-ended written responses in which participants identified their top three required reforms. Responses were segmented and coded into 18 mutually exclusive categories via a validated codebook, and prevalence was calculated using respondent-normalized weights. We then examined demographic, well-being, and personality correlates of reform priorities using χ² tests, Mann–Whitney tests, and multivariable logistic models with Benjamini–Hochberg false discovery correction. Teachers most frequently prioritized competency development and pedagogical reform, followed by curriculum flexibility and system governance. Reform priorities were not random: female teachers were substantially more likely to prioritize inclusion and SEN support, while male teachers more often prioritized governance and depoliticization; older age predicted governance priorities. Lower educational system satisfaction robustly predicted prioritizing curriculum reform, autonomy, and governance restructuring, and anxiety and depression were positively related to curriculum concerns. Conscientiousness predicted prioritizing salary and material recognition. The results indicate that teachers’ reform demands function as systematic, psychologically grounded signals that can guide more targeted, teacher-centerd educational policy in Hungary. Full article

In contemporary scholarship, pilgrimage is increasingly analysed as a practice associated with personal transformation, spiritual reflection, and psychological well-being. Among the most popular contemporary pilgrimage routes, the Camino de Santiago attracts hundreds of thousands of participants each year, many of whom describe their journey in explicitly therapeutic terms. This article examines the Camino experience through the theological category of penance understood as a form of spiritual therapy within the Christian tradition. The main argument of the study is that the early Christian understanding of penance as spiritual medicine provides a meaningful interpretative framework for analysing the therapeutic experiences reported by contemporary pilgrims. Early Christian authors such as Hermas, Tertullian, and Cyprian described sin as a spiritual illness and penance as a process of healing and restoration. Within this perspective, practices involving physical effort, repentance, prayer, and moral transformation functioned as forms of spiritual therapy (gr. θεραπεία). The article combines theological and empirical approaches. Analyses the concept of penance as spiritual healing in early Christian sources and traces its historical connection with penitential pilgrimage. Presents qualitative research based on semi-structured interviews conducted with pilgrims on the Camino de Santiago. While the participants rarely framed their experiences explicitly in penitential terms, their testimonies reveal recurring themes of inner purification, emotional reconciliation, coping with illness or personal crisis, and the search for meaning. The findings suggest that these experiences can be meaningfully interpreted through the lens of the Christian understanding of penitential practice, particularly as a process of transformation and restoration. Rather than demonstrating a direct continuity, the study proposes an interpretative perspective that highlights structural similarities between historical theological models and contemporary experiential narratives. By integrating theological reflection with empirical data, the article contributes to debates on how historical religious concepts can illuminate contemporary experiences of healing, meaning, and well-being. Full article

Background/Objectives: Anaplastic thyroid carcinoma (ATC) is one of the most aggressive and lethal forms of malignant neoplasm of the endocrine system, and osteopontin (OPN) has been shown to be aberrantly expressed in this tumor type. Among the five OPN splicing isoforms (OPN-SI), OPN-4 has been recently reported in several tumor types, including ATC, but its functional role(s) have not yet been elucidated. Methods: To characterize OPN-4 roles in ATC cells, OPN-4 was ectopically overexpressed in the c643 ATC cell line, generating the c643/OPN-4 cells. OPN-roles were evaluated by cell functional assays, including cell proliferation and viability, using Carboxyfluorescein Succinimidyl Ester (CFSE), crystal violet, and trypan blue assays. For migration, clonogenicity, cell cycle and apoptosis assays were used. For assessment, c643/OPN-4 cells were cultured in two-dimensional (2D) monolayers or three-dimensional (3D) spheroids with the latter being maintained in a bespoke microfluidic system. Results: OPN-4 overexpression led to a significant reduction in cell proliferation, viability, migration and clonogenicity. c643/OPN-4 cells displayed a significant accumulation in the G0/G1 phase and a decrease in the S phase of the cell cycle; however this did not affect cell death or the expression levels of other OPN-SI. In a spheroid model of c643/OPN-4 cells, no significant differences were found in spheroid size or viability when compared to those formed by control cells. Notably, OPN-4 overexpression enhanced the effects of sorafenib on cell viability under dynamic treatment conditions involving continuous perfusion. Conclusions: These early findings point to the fact that OPN-4 may reduce some aspects of tumor progression features in ATC cells and open new avenues for investigating OPN-4 as a biomarker of therapeutic response in personalized treatment strategies. Full article

The purpose of this study was to examine the multivariate relationship between college students’ Big Five personality traits and their perceptions of generative artificial intelligence (AI). Guided by sustainable digital education and expectancy-value theory, this study investigated whether personality profiles were associated with students’ knowledge of AI, attainment value, intrinsic value, utility value, perceived cost, and intention to use AI. Using a cross-sectional survey design, data were collected from 375 students enrolled at a Southwestern doctoral-granting public university. Participants completed an adapted measure of generative AI perceptions and the Big Five Inventory, and canonical correlation analysis (CCA) was conducted to examine the multivariate relationship between the two variable sets. The results indicated that the full canonical model was statistically significant and that three interpretable canonical functions were retained. The first and strongest function showed that higher openness, agreeableness, and conscientiousness were associated primarily with greater AI knowledge and, to a lesser extent, with higher perceived cost. The second function indicated that higher neuroticism was associated with greater perceived cost and lower utility and attainment value. The third function showed that lower neuroticism, together with higher openness and conscientiousness, was associated with a stronger attainment value, greater intention to use AI, and lower perceived cost. Our findings suggest that students differ meaningfully in how they understand and value generative AI. These results have important implications for higher education because they highlight the potential value of differentiated, human-centered AI literacy efforts in supporting more equitable and responsible AI integration. Full article

Deepfake content forgery compromises the integrity of digital media and the protection of personal identity, making its detection essential for preserving trust and enabling effective forensic analysis. Most deepfake detection approaches focus on global classification with a binary decision, which is inadequate for precise localization of manipulated regions. This limitation becomes particularly evident under image processing distortions. This paper proposes a dual-decoder architecture for the detection and segmentation of original and deepfake facial manipulations. Unlike conventional single-decoder segmentation models, the proposed approach introduces two decoding branches that learn complementary feature representations of authentic and forgery facial textures. In addition, attention mechanism modules are incorporated to refine encoder features based on decoder context, introducing adaptive feature selection during reconstruction. This architectural design reduces feature interference during reconstruction and enhances the localization of subtle inconsistencies introduced by deepfake manipulations. This approach generates complementary masks for real and forged regions, providing more precise boundary delineation. Experimental results highlight the robustness of the proposed method under image processing distortions, achieving intersection over union (IoU) scores of 0.9387 for real faces and 0.9254 for deepfake segmentation. These results underscore the effectiveness of the dual-decoder architecture in accurately detecting and localizing deepfake facial manipulations. Full article

As natural nanoscale intercellular messengers, exosomes exhibit considerable potential in modulating inflammation, angiogenesis, immunoregulation, and tissue remodeling, making them attractive candidates for regenerative medicine. However, their clinical translation remains limited by rapid systemic clearance, nonspecific biodistribution, insufficient lesion retention, and functional attenuation in hostile pathological microenvironments. In this review, we propose that biomaterial engineering should evolve from providing passive exosome carriers to constructing active regulatory platforms capable of precise spatiotemporal control. We summarize engineering strategies along two complementary dimensions. In the temporal dimension, biomaterials can enable sustained, sequential, or microenvironment-responsive release to match the dynamic phases of tissue repair. In the spatial dimension, biomaterials can improve local retention, tissue anchoring, structural guidance, endogenous cell recruitment, and lesion-specific delivery. Using cutaneous wound healing, osteochondral regeneration, myocardial repair, and neural regeneration as representative examples, we further analyze these strategies through a “clinical challenge–engineering strategy–biological mechanism” framework, with particular attention to how engineered systems influence key signaling pathways such as PI3K/Akt, Wnt/β-catenin, NF-κB, and PTEN/PI3K/Akt/mTOR. We also discuss translational barriers, including exosome heterogeneity, safety concerns inherited from parental cells, large-scale GMP-compliant manufacturing, product standardization, storage stability, and regulatory classification of exosome–biomaterial hybrids. Finally, we highlight emerging directions, including multi-mechanism combinational systems, closed-loop responsive platforms, and artificial intelligence-assisted design for personalized exosome therapeutics. This review provides a design-oriented framework to accelerate the bench-to-bedside development of biomaterial-enabled precision exosome therapy. Full article

Pharmaceutical care provides the conceptual foundation for integrating pharmacogenetics into everyday pharmacy practice. Defined by Hepler and Strand as “the responsible provision of drug therapy for the purpose of achieving specific outcomes that improve a patient’s quality of life”, pharmaceutical care emphasizes a patient-centered approach in which the pharmacist collaborates with the patient, physician, and other healthcare professionals to design, implement, and monitor individualized therapeutic plans. In this context, pharmacogenetics can be regarded as an extension of pharmaceutical care: while the traditional model relies on monitoring patient outcomes and adherence, PGx adds a genetic dimension that allows treatment to be optimized from the very beginning. The pharmacist’s role therefore evolves from not only ensuring safe and effective use of medicines, but also interpreting genetic test results, supporting adherence to genetically guided therapy, and educating patients about the implications of their personal genetic profile. The introduction of pharmacogenetics testing as one of the potential services offered by community pharmacies is a promising proposition that may revolutionize the approach to drug therapy. Pharmacogenetics, a subset of pharmacogenomics, focuses on the study of DNA sequence variations that influence response to drugs. Thanks to advances in the field of genomics, it has become possible to study the genetic basis of variability in drug response. The identification of alleles responsible for the rapid or slow metabolism of xenobiotics has ushered in a new era in pharmacology. The aim of this interdisciplinary field, combining genetics and pharmacology, is to adapt treatment to a specific patient based on the analysis of their genome and gene polymorphism. Throughout the world, pharmacogenetics is gaining importance as a tool for personalizing medicine. In countries such as the United States, Canada, and the United Kingdom, programs integrating pharmacogenetics with healthcare are being developed. Clinical trials and the implementation of genetic tests into medical practice allow for better matching of medications and reducing the risk of side effects. Pharmacists will play a key role in integrating pharmacogenetics into healthcare. As specialists in the field of pharmacotherapy, they will support physicians in interpreting the results of genetic tests and adapting drug therapy to the individual needs of the patient. Additionally, pharmacists can educate patients and healthcare professionals about the benefits of pharmacogenetics and monitor the effects and safety of medications. Their involvement in the process of personalization of treatment may contribute to improving the effectiveness and safety of pharmacological therapies. Full article

The transformation of university libraries into learning commons has highlighted the importance of informal learning spaces (ILSs). However, the mechanisms through which spatial elements influence learning experiences remain underexplored, particularly in western China. Drawing on person-environment fit theory and a multi-coupling framework, this study develops a four-dimensional analytical model comprising spatial layout, facility configuration, environmental quality, and cultural perception. A mixed-methods approach was employed, including 532 valid questionnaires, behavioral observations, and comprehensive environmental measurements (illuminance, noise, CO₂, PM2.5, TVOC, thermal conditions) across three university libraries in Lanzhou, China. Structural equation modeling (SEM) and coupling coordination degree modeling were used for analysis. Spatial layout (β = 0.324, p < 0.001), facility configuration (β = 0.287, p < 0.001), environmental quality (β = 0.196, p < 0.01), and cultural perception (β = 0.158, p < 0.05) all significantly predicted learning satisfaction, jointly explaining 67.3% of the variance. Learning satisfaction partially mediated the relationship between spatial elements and learning outcomes (indirect effect 31.2%). Coupling coordination degrees ranged from 0.578 to 0.634, revealing a “high coupling, low coordination” pattern, with cultural perception as the common shortfall. Environmental measurements showed CO₂ concentrations ranging from 823 to 946 ppm in quiet zones and up to 1085 ppm in lounge areas, correlating negatively with satisfaction (r = –0.41, p < 0.05). Spatial elements influence learning outcomes primarily through satisfaction enhancement. An integrated optimization framework is proposed, offering actionable strategies for ILS design in similar contexts. Full article

Background/Objectives: Adults with intellectual disability are known to experience complex health needs, including an elevated presence of chronic conditions. Cardiovascular risk factors are a concern, yet the evidence base is fragmented, and the scope and focus of current research are not well understood. Methods: We conducted a scoping review to map the existing evidence on cardiovascular risk factors among adults with intellectual disability. The review included studies reporting on risk factor prevalence as well as participant characteristics (ethnicity, living arrangements, age, sex, and type of disability). Cardiovascular-related outcomes were extracted to clarify the health disparities documented in this population. Results: Searches of seven databases for studies published from 2013 onward yielded 15,598records, of which 85 met the inclusion criteria. Evidence was dominated by cross-sectional studies, with a few randomized controlled trials. Hypertension, Type 2 diabetes and obesity were commonly reported. Patterns appeared to reflect lifestyle, medication effects, genetic syndromes—particularly Down syndrome and Prader–Willi syndrome—and the severity of the disability. A notable share of the studies originated from the United Kingdom and the United States. Findings reveal a complex cardiovascular risk profile, emphasizing the need for tailored prevention and management. Conclusions: Adults with intellectual disability face a substantial burden of cardiovascular risk factors. Evidence on effective interventions remains limited, highlighting a need for targeted, evidence-informed approaches to improve cardiovascular health and long-term outcomes. Full article

Background/Objectives: We aimed to test two different visual arrays for helping individuals accurately interpret colorectal cancer risk in Lynch syndrome. We also sought to examine factors associated with intention to share genetic test results with blood relatives. Methods: Participants were recruited through Amazon Mechanical Turk (July–August 2025). Participants completed an online REDCap survey evaluating genetic literacy/numeracy and risk perception (Tripartite Model of Risk Perception). Participants were randomized to a risk visualization—either a standard icon array or a sequential icon array intended to decrease cognitive load. Subsequently, participants were randomized to a communication choice scenario—a nondirective (choice) frame or an “enhanced choice” with a behavioral nudge based on the Theory of Planned Behavior. Results: Participants’ (n = 1041) estimation of colorectal cancer risk did not differ according to visualization type (icon array: 60.36 ± 15.86%, sequential array: 60.91 ± 15.73%, p = 0.58). Intention to share genetic testing outcomes with family members was not influenced by the behavioral nudge (p = 0.23). Neither risk estimation nor intent to communicate results to blood relatives were affected by individual perceived colorectal cancer risk, health literacy/numeracy, education, previous genetic testing, personal cancer history, or family cancer history (all p > 0.11 and p > 0.21, respectively). Conclusions: This study found that visual array type did not affect estimated cancer risk, and decision frame did not affect intention to share genetic testing results. Findings could inform the development of online approaches to expand decision support for hereditary cancer syndromes (Clinicaltrials.gov #NCT06994832). Full article

Introduction: Despite proven efficacy of anti-TNF agents in inflammatory bowel disease, primary non-response affects up to one-third of patients, while secondary loss of response occurs at 13–21% per patient-year, often requiring dose optimization or switching to alternative advanced therapies. Methods: The present single-center cohort study at the University Hospital of Ioannina included biologic-naïve patients receiving anti-TNF therapy as their first biologic treatment. First anti-TNF treatment failure was defined as discontinuation due to persistent IBD activity despite maximal dose optimization (infliximab 10 mg/kg every 4 weeks, adalimumab 40 mg weekly). Patients with measurable anti-drug antibodies prior to anti-TNF dose intensification or discontinuation were excluded. Of 528 anti-TNF-treated patients, 286 (173 with CD, 113 with UC) met the inclusion criteria and were included in the final statistical analysis. Results: Anti-TNF failure occurred in 32.7% of Crohn’s (CD) and 32.9% of ulcerative colitis (UC) patients. Multivariable Cox regression identified complicated phenotype (stricturing or/and penetrating CD; HR = 1.9, p = 0.032) and concomitant corticosteroid use at anti-TNF initiation (HR = 2.03, p = 0.012) as independent predictors of anti-TNF failure in CD. Age at CD diagnosis showed a trend for statistical significance (HR = 1.02, p = 0.061), and after stratification, age at diagnosis ≥ 40 years conferred higher risk (HR = 1.93, p = 0.016), alongside persistent effects of complicated phenotype (HR = 1.83, p = 0.027) and corticosteroid use (HR = 2.01, p = 0.013). In UC patients, female sex predicted anti-TNF failure (HR = 2.13, p = 0.025). IBD-related bowel resection occurred in 26.6% of patients with CD and in 5.3% of patients with UC. Conclusions: Anti-TNF failure remains common despite optimization. Identifying immunogenicity-independent predictors may enable personalized treatment strategies and improve outcomes. Full article